Individual provider Active NPI

Brian Kevin O'Connor, M.D.

  • Pediatric Cardiology Physician
  • West Orange, NJ
National Provider Identifier
1275647216
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
25MA07011500 Issued in NJ
Practice address
375 Mount Pleasant Ave
West Orange, NJ 07052-2724
Phone
(973) 731-9442
Fax
(973) 731-2918
NPI assigned
Aug 18, 2006
Last updated
Apr 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 25MA07011500 NJ Primary

Addresses

Primary practice location

375 Mount Pleasant Ave
West Orange, NJ 07052-2724

Mailing address

375 Mount Pleasant Ave
West Orange, NJ 07052-2724
Phone (973) 731-9442

Other identifiers 1

IdentifierTypeStateIssuer
6617000MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080919000157 NJ Practitioner - Pediatric Medicine 3274600036 Reassigns benefits to 3 organizations
I20240311002629 NY Practitioner - Pediatric Medicine 3274600036 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA70115NJMDCardiovascular Disease Physician
25MA07011500NJMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 13, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Jan 13, 2024 Accepting new patients
Pediatric Cardiology Associates PC CurrentSince Sep 17, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Rwjbh Observation Associates LLC CurrentSince Oct 28, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients

Locations

102 James St
Edison, NJ 08820
Phone (732) 494-4958

1 Broadway
Ste 203
Elmwood Park, NJ 07407
Phone (973) 569-6250

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

201 Lyons Ave
Ste C9
Newark, NJ 07112
Phone (973) 926-7203

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

101 Old Short Hills Rd
Ste 120
West Orange, NJ 07052
Phone (973) 731-7868

375 Mount Pleasant Ave
West Orange, NJ 07052
Phone (973) 322-6900

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • Direct secure messaging: boconnor229353@epicdirect.rwjbh.org
  • Direct secure messaging: brian.oconnor@pedcard.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AFAHCA/Endpoint/AFAHCA

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1275647216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522724",
            "telephone_number": "973-731-9442",
            "fax_number": "973-731-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522724",
            "telephone_number": "973-731-9442",
            "fax_number": "973-731-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "BRIAN",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NJ",
            "license": "25MA07011500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6617000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.